New guidelines will make ‘abortion pill’ easier to obtain

The U.S. Food and Drug Administration guideline revision, the first since the drug formerly known as RU-486 was approved in 2000, is expected to allow Texas women to take one of the medication’s two components without the supervision of a doctor. This photo is of the generic version of one of those components, misoprostol. (Molly Hennessy-Fiske/Los Angeles Times/TNS)

Photo: Molly Hennessy-Fiske /TNS

AUSTIN — The Texas Legislature’s crackdown on the so-called “abortion pill” suffered a surprising setback Wednesday when the federal government announced new guidelines that will make the drug easier to obtain.

The U.S. Food and Drug Administration guideline revision, the first since the drug formerly known as RU-486 was approved in 2000, is expected to allow Texas women to take one of the medication’s two components without the supervision of a doctor and to undergo the entire process later in the first term of pregnancy.

The changes align the federal rules with most doctors and state regulators, who largely already had moved away from the old guidelines in response to medical research showing that they were unnecessarily strict for a safe drug.

Texas was a notable exception, however, along with Ohio and North Dakota. Lawmakers here sharply limited the use of the drug in 2013 by adhering to the federal guidelines and imposing a litany of other regulations that collectively required women seeking the medication to visit their doctors four separate times.

The result had been a drastic reduction in medication abortions. Whole Woman’s Health, a Texas-based provider, has said that its rate of drug-induced abortions dropped from more than 40 percent of procedures to about 5 percent after the passage of House Bill 2.

Due to Wednesday’s change, Texas women are expected to only have to go to a doctor’s office three times.

“Today science has prevailed where the state Legislature has failed,” said Yvonne Gutierrez, executive director of Planned Parenthood Texas Votes, in a statement.

Texas health officials declined to comment on the guideline revision, saying they still were analyzing its impact.

Anti-abortion activists acknowledged that the change is almost certain to make the drug more accessible to women.

“We’re not happy,” said Joe Pojman of the Texas Alliance for Life. “We think it’s a step backward, not forward.”

The federal government’s announcement abruptly thrust the medication protocol known as mifepristone and misoprostol to the forefront of the abortion debate, which had been consumed with a U.S. Supreme Court case over other Texas regulations.

The justices are expected to issue a ruling by June on the constitutionality of regulations requiring abortion doctors to obtain admitting privileges at nearby hospitals and abortion clinics to comply with the expensive standards of hospital-style surgical centers.

Those changes were part of the same legislation that imposed the regulations on drug-induced abortions: House Bill 2, which was approved over a filibuster by then-Democratic state Sen. Wendy Davis.

It mandated that abortion providers follow the federal guidelines, including that both components of the medication be taken in the presence of a doctor. It also required a follow-up appointment, in addition to the initial consultation that is required for all abortions under Texas’ sonogram law.

The provision received less attention than other parts of the law but still was a point of contention in the state Capitol and the courts. A lawsuit challenging that portion of the law was rejected by a federal appeals court in 2014.

The new guidelines say the second component of the medication should be taken “at a location appropriate for the patient.” That likely means at home, which would erase the need for one of the visits, activists said.

The federal government’s new label also allows a woman to take the drug up to 10 weeks after the beginning of her last menstrual period, up from seven weeks.

Another change is less likely to be felt in Texas, however. The new label lowers the dosage of the drug to be more in line with what is recommended by the medical community, but House Bill 2 requires the dosage to be what was recommended as of Jan. 1, 2013.

The American Congress of Obstetricians and Gynecologists said in a statement it was “pleased that the updated FDA-approved regimen for mifepristone reflects the current available scientific evidence and best practices.”